THIRD PERSON

"Nervous?" Dr. Frondoja asked while fixing her coat as she glanced to Dr. Aguillard sitting on a bench.

"A bit," sagot naman ni Dr. Aguillard.

"Well, don't be. We're here to help you. Don't worry, it'll be okay." Binigyan siya ng ngiti ni Dr. Frondoja.

"I don't know where to start."

"You do." Lumapit si Dr. Frondoja kay Dr. Aguillard saka siya nito binigyan ng isang tapik sa balikat bago lumabas sa locker room nilang mga doktor.

Dr. Aguillard heaved a sigh. This is the day that they have been waiting for. They're going to present the case of Genevieve Hutton to the board members of the hospital. Pumikit siya nang mariin at kinalma ang sarili niya. Tumayo siya at agad na lumabas sa locker room. As he entered the conference hall, everyone greeted him with applause and standing ovation. Nakarating siya sa unahan na may mini stage saka tumapat sa mikropono.

"Everyone, good day! Please, have a seat," panimula ni Dr. Aguillard sa mga nasa loob ng conference hall. "I decided to call a meeting today because I need the approval of the board members especially the director of this hospital, sir," Dr. Aguillard paused for a while to greet the director of the hospital. "To use all the possible equipment that this hospital have to treat my patient. I'm also here to discuss to you about the case of my patient. I need your help, that's why."

Biglang umingay ang buong paligid nang marinig nila ang sinabi ni Dr. Aguillard. Siguro dahil alam na rin ng ibang taong nasa ospital na ito ang kakaibang kaso ng pasyenteng si Genevieve Hutton.

"Dr. Aguillard."

Natahimik agad ang buong paligid nang magsalita ang director.

"Sir?"

"Are you going to use even the new but dangerous equipment that this hospital have? Wala pang nakakasubok sa ilang kagamitang iyon. And how sure are you that it's effective?"

"Yes, Sir. As much as possible, all the equipment that I'll need to treat my patient. It's a win-win situation."

"Are you sure about that, Dr. Aguillard? What if the chance is only one percent? Are you still going to proceed?"

Sandaling natahimik si Dr. Aguillard dahil sa tanong sa kanya ng direktor.

"Hangga't may chance kahit na 0.01%, I will still do it for the sake of my patient. That's the job of the doctors."

"For the sake of your patient? How? This is between life and death you are talking about, Dr. Aguillard. What if you fail? What will happen to the patient? What will happen to the reputation of our hospital? Do you think this is just a joke to you? Gagamitin mo ang ilan sa mga kagamitan ng ospital na wala pang kasiguraduhan. Masyadong nakakabahala. Our specialists are still working on it and you know that," paliwanag naman sa kanya ng direktor.

"Sir, this is not about life and death. Although, it can be. But, this is about a survival and success. If we succeed, the patient will survive and going to live again just like her past life. All we need to do is to think positive in order to save the patient."

"Positive thinking is not the case here, Dr. Aguillard. Hindi uubra ang positibong pag-iisip kung hindi ginagamit nang mabuti ang isip sa kakaibang paraan sa pagpapagaling ng pasyente. You should think before you act. Think differently. Think of the possible consequences if you take the risk. Think of your patient. What will be the best way to treat your patient? And what will be the suitable treatment and medications for her? Possibilities, Dr. Aguillard."

"Thank you for your advice, Sir Freigh. But, I already made up my mind. Matagal ko itong pinag-isipan. Hindi naman ako gagawa ng mga bagay na ikasasama ng pasyente ko. All we need to do is to try and see the miracle. Imposible man o hindi, gagawin ko." Dr. Aguillard smiled and he received a round of applause from the audience.

"Ah, Dr. Aguillard. Trying can't help you succeed in this case and miracle is such a lame excuse. This is already a 21st century, hindi na umuubra ang pagsubok at paghintay lang ng himala sa mga katulad ng kasong ito. It all depends to the person who's going to treat the patient. It all depends on the machine. In short, technology."

"Sir, with all due respect, it still exist. Miracle and trying still exist in this generation. Kaya nga tayo naging mga doktor dahil sa pagsubok, hindi ba? Kaya tayo nandito ngayon because of trying. Kung wala tayo ngayon, hindi rin masusubukan ang pasyenteng nangangailangan ng tulong natin na magamot. Trying in the past makes the present exist. Having a miracle is what God created. And now, trying to treat my patient is what the future holds for her survival. Trying... and doing it at the same time. And praying makes the miracle come true. This is not about the machine and how professional are we now, this is about hope and believing in Him. O kahit tungkol pa ito saan as long as the patient lives."

Natahimik ang buong hall at wala ni isang nakakibo. Pero pinaglaban pa rin ng direktor ang prinsipyo at kaalaman niya.

"You're a doctor, not a philosopher, Dr. Aguillard. We believe in the facts and reality, not on assumptions and pathetic sayings."

Hindi nakaimik si Dr. Aguillard.

"Anyway, let's proceed to the discussion," tanging nasabi ng direktor. "I'll look forward to your case and where your principles in life will lead you."

Napangiti na lang si Dr. Aguillard saka bahagyang yumuko. Umalis siya sa unahan at sinalubong naman agad siya ni Dr. Frondoja at Dr. Sylvan.

"That was tough. You forgot that you're talking to the director, aren't you?" Dr. Frondoja said, ignoring what the director has said.

Napangiti na lang si Dr. Aguillard sa kanila.

"Well, what do we expect from the experienced doctor?" segunda naman ni Dr. Sylvan.

***

"Genevieve Hutton, an 18-year-old girl suffering from waterborne hives, also known as water allergy. Her parents said that she continues to have recurring bouts of hives before, during and after her 18th birthday, but my diagnosis of her is different. It says she's just allergic to beauty products, and because it's natural, it's not alarming. But the fact that she brought back here almost three weeks ago gave me the impression that make-up was not the true explanation behind it. It's a lot more than that. So, I've been searching for her case and I've been running some tests on her case, but it's all bad. Until we come to the realization that we really don't know what's wrong with her," Dr. Aguillard said. "Dr. Frondoja's patient gave us a tip, and that's when we find that Genevieve Hutton is suffering from an unusual allergy in the world called Aquagenic Urticaria and that causes her body to develop this kind of allergy that produces compounds that are stranger to her mast cells. The chemicals in her skin are mixed together, causing her upper body to grow rare hives. The patient's parents also said they saw their daughter drink a wine on her 18th birthday at the bukod doon ay wala na. So, I think, iisa lang ang naging creation ng allergy niya because wine contains water and other compounds that the mast cells cannot handle. It started with the wine, and then it got worse because of the rain."

Halata sa mga mukha ng taong nakikinig sa kanya ang pagiging interesado rin sa kaso, maging ang direktor ay tahimik lang.

"Upon contact with water, the symptoms will slowly show, in ten minutes or longer, a very itchy and uncomfortable skin reaction. Yet nobody really knows why certain people have this odd reaction to the water. However, it has been noted that allergy seldom runs in families. It is caused either by a liquid immersed in water instead of the water itself, or by an association between the water and the substance present on the skin. For those with water allergies, therapies and drugs are limited but have been reported to be validated and tested. However, aquagenic urticaria can not be eliminated until the triggers that caused the disorder are known, more and future flare-ups can be avoided. The use of sufficient oil-creams and ointments, which serve as a shield against direct skin contact with water, can prevent further episodes of the disease." Dr. Aguillard switched his position on the stage. "So, to further understand the allergy, Dr. Frondoja will discuss to you the reported cases since 1958 until last year. Ladies and gentlemen, thank you." Umalis si Dr. Aguillard sa stage para ibigay naman kay Dr. Frondoja ang spotlight.

"Everyone, good afternoon. Today, I'm going to present to you a two different reported cases about water allergy. I know this is too far from Ms. Hutton's case but it can give us an idea on how to cope up with it. So, let's start with Mr. Bryton Lamm, a 26-year old man and a surgeon in Germany," Dr. Frondoja stopped as he looked at the picture of Mr. Lamm projected on a big screen. "He said that he suffered a recurrent episodes of unusual hives when he took a bath or shower and a pinpoint sized wheals affects his scalp, shoulders, arms, trunk, abdomen and back. These symptoms appeared within ten or more minutes of contact with water. The patient has no personal history of asthma or drug allergies and no family history of aquagenic urticaria. Various tests were performed like a water-challenge test, pressure test, exercise test and an ice-cube test and the response to the tests was all positive. Based on these findings, a diagnosis of aquagenic urticaria has been made," Dr. Frondoja explained. "Fexofenadine and capsaicin were administered and no lesions formed after a month of contact with water. It's also an indication that Mr. Lamm's treatments were successful and that he was still a symptom free after a year. He continued to live and became a prosperous surgeon in Germany until he got married. And now, he's living with his wife and daughter peacefully without having an allergies and diseases. Their family is as healthy as the new born baby."

Everyone inside the showed their different reactions about the case. Mahirap paniwalaan ang ganitong kaso pero wala silang magagawa kundi ang maniwala dahil sa mga ibinibigay na impormasyon sa kanila. Yes, they're doctors but this kind of allergy is new to their ears. They never heard about this allergy before so it catches their attention to listen attentively in every single word and phrase that Dr. Aguillard and Dr. Frondoja had said.

"Nothing is impossible, nothing is a miracle. It all happened because of Him, and I thank Him for that, because it made me realize so many things in my life. Only go with the rhythm of nature and it will come to the right location, Dr. Bryton Lamm said during his German News interview."

Dr. Frondoja received an applause from the audience.

"Now, let's proceed to the second case. Believe me, hindi rin kami naniwala noong una but the information are saying it all. Keva Lashman, a 4-year-old little girl who also suffered a recurrent episodes of hives-"

Napatigil si Dr. Frondoja nang biglang lumakas ang ingay sa loob.

"Ah, everyone? May I have your attention again, please?"

Agad namang nabalik sa dating tahimik ang loob ng hall.

"Thank you. As I was saying, a 4-year-old girl named Keva Lashman sufferend a recurrent episodes of hives. Her parents told her doctor that a pinhead-sized whale appeared on her cute little face, extremities, chest, abdomen, and back when she took a bath or a shower to swim in the pool. The symptoms appeared within twenty minutes of contact with water and lasted approximately thirty or sixty minutes and showed spontaneous resolution," Dr. Frondoja said, "Like Mr. Lamm, multiple studies have been carried out and the reaction to the tests has also been positive. As a result, ketotifen syrup was originally recommended at a dosage of 5 ml per day for symptom relief. After three weeks, no water touch lesions had formed. The signs of aquagenic urticaria ceased after her fifth birthday. Now that she's six years old, she's no longer afraid to go outside and play with her peers. She's also enjoying a happy time with her family." Naglakad siya palapit sa lamesang nakalaan para sa mga files nila. Nilapag niya agad 'yong mga papel na hawak niya.

"So..." She clapped her hands as she face the audience again, "Let's proceed to the discussion, shall we? But before that, do you want to clarify something? None? Okay!" She stopped mid-step. "In addition to the recorded cases, there are also twin sisters who have had repeated outbreaks of aquagenic urticaria, but later that day, their physicians learned that one of them is only allergic to cold water and the other is only allergic to hot water. It's not that risky to them, since it can be quickly avoided, but drugs can vary in different ways. So, let's proceed." Dr. Frondoja smiled to the audience.

"Aquagenic Urticaria or water allergy is more prevalent in women than in men and occurs in puberty or many years later. And as you can see in the case of Keva and Mr. Bryton, it seems that the AU is not fatal and can be handled quickly. Since Keva is still too young to suffer from this kind of disease, the exact process has not been properly identified. It's also the same to Avein and Avian, the twin sisters. It seems that most cases are sporadic but on Genevieve's case it's different," she paused as she looked at Dr. Aguillard saka ulit nagpatuloy. "We ought to conduct all necessary scans and therapies to figure out what's actually wrong with her body. Whether it's either allergic to heat or cold, even whether it's allergic to all kinds of liquids and temperatures. It would be safer if we did it while she's awake because it would be really difficult for us to reconcile the state of her body with the examinations that we're going to do when she's asleep. However, we still need to perform several tests to-"

"Well, this case is all depends to Dr. Aguillard, right? We're just going to watch all of his actions throughout the whole testing process," biglang singit ng direktor kaya saglit ulit na napatigil sa kanyang pagsasalita si Dr. Frondoja.

Nagkatinginan naman si Dr. Frondoja at Dr. Aguillard, nangungusap sa mga mata nila.

"Actually, Sir, tatlo po kaming nasa kasong ito," ani Dr. Frondoja.

"So, I expect more to your actions. Don't disappoint me. I might shift you to the other department or worst fire you kapag may nangyaring hindi ko nagustuhan."

Nginitian lang ito ni Dr. Frondoja.

"I would gladly do so, Sir." Saka siya bahagyang yumuko.

Samantalang si Dr. Aguillard ay hindi man lang nakaramdam ng takot sa mga sinabi sa kanila ng director bagkus ay lalo siyang na-motivate na iligtas ang pasyente. Wala na siyang pakialam pa sa sasabihin ng ibang tao sa kaso niya as long as her patient lives.

"There are some treatment naman that had been used to lessen the effects of AU and to promote more comfort when the body comes in contact with water. Wala naman pong mawawala kung susubukan natin, hindi ba? As long as we believe that she would survive it. I'm pretty sure that the patient will live like her normal life before."

Lumipas pa ang isang oras ng pagdidiskusyonan sa loob ng hall bago tuluyang nag-adjourned ang naturang meeting tungkol sa kaso ni Genevieve Hutton. Although may mga hindi pa rin naniniwala sa ganoong kondisyon at nahirapan din silang patunayan iyon, they still push it and mark the end of the discussion as they finished presenting it.

It's a tough day for them. They still need to prepare themselves para sa darating pang mabibigat na mga araw. No slacking all day long, just figuring out the best suitable solutions to Eve.